ASSOCIATED FACTORS OF PARTICIPATION IN DIGITAL TECHNOLOGY: A STUDY BASED ON OLDER PEOPLE IN CHINA

Abstract There has been an increasingly important trend that more and more older people take part in activities of digital technology nowadays in China. In this study, the research question associated to determinants of older people’s digital engagement was addressed, which has been quantitatively analyzed by statistical models in a sample of older people 60 to 98 years of age from China Longitudinal Aging Social Survey (N=11207). For dependent variable, digital participation of older people has been measured by the access to the Internet with mobile phones and various digital devices, whereas for independent variables, individual, situational, environmental, and social policy factors which were based on a conceptual model of productive aging framework have been constructed to present academic explanations on dependent variable. Results of Probit and Ordered-Probit regression showed that the older people’s participation in digital technology was closely related to individual and situational factors, whereas the effects of environmental factors and social policies were not statistically significant. Older adults who were much younger and physically healthier had higher probability of participation in digital technology. Meanwhile, those who lived in urban area, had higher levels on income, literacy and social support were more likely to be involved in digital activities. Conclusions shed light on the significance of academic research to improve productive ageing and successful ageing which takes a more active role on exploring and grappling with issues related to application of digital technology especially technological difficulties that older people have confronted with in an ageing society.

decisional competence, but how these criteria are applied in clinical practice remains unknown.This study examined qualitatively which factors, and how, influence the judgment of decisional competence for EAS requests of people with dementia.Thematic analysis of 60 dementia EAS case summaries published online by the RTE between 2012 and 2021.Twenty patients had an advance directive and were decisionally compromised at time of EAS.Forty patients were decisionally competent at time of EAS, of which twenty also had an advance directive (purposive sampling).Two researchers independently coded all text related to decisional competence.A theoretical framework was developed.The four cognitive criteria of Appelbaum and Grisso were dimensional and cut-off points were influenced by six supporting factors that also directly impacted on competence assessment, i.e., level of communication, psychiatric comorbidity, personality, presence of an advance directive, consistency of the request, and the patient-physician relationship.The number of involved physicians and executed investigations were two contextual factors.The multidimensionality and subjectivity of decisional competence assessment may pose ethical and legal challenges.Continuous quality improvement processes may be needed in daily care, including possibilities for reflection.

ASSESSMENT OF DEFICITS IN SPECIFIC COGNITIVE DOMAINS IN OLDER ADULTS LIVING WITH HIV (OALWH)
Andrea Reyes-Vega 1 , Harideep Samanapally 1 , Rishikesh Rijal 1 , Stephen Furmanek 2 , Christopher B. Shields 3 , Brandon C. Dennis 3 , Smita Ghare 3 , and Shirish Barve 3 , 1. University of Louisville, Louisville, Kentucky, United States, 2. Norton Infectious Diseases Institute, Louisville, Kentucky, United States, 3. Norton Neuroscience Institute, Louisville, Kentucky, United States A significant proportion of people living with HIV (PLWH) have cognitive impairment.Moreover, approximately 70% of PLWH in the United States will be ≥50 years old by 2030, raising concerns of a higher incidence of dementia as they age.Accordingly, there is a clinical need to monitor their cognitive status.The aim of this study was to delineate specific cognition areas impacted in OALWH with a clinical diagnosis of neurocognitive impairment.We used a comprehensive set of tests (paper and NIH Toolbox Cognition Battery), to assess different cognitive domains in a total of 25 OALWH ≥ 50 years.64% were diagnosed with neurocognitive impairment and 36% were non-impaired.T-scores were compared using t-tests of means.Differences in means and 95% confidence intervals (CI) were reported.Impaired patients scored on average 18.35 T-score points lower on Hopkins Verbal Learning Test (HVLT) retention trial (p 0.016, CI:6.74-29.97)and 9.19 T-score points lower on the NIH Picture Vocabulary Test (PVT) (p 0.033, CI:1.12-17.26).Stroop color word, NIH Card Sort and NIH Picture sequence memory test were trending to be significantly lower in impaired patients (p< 0.07).In impaired OALWH, the HVLT data demonstrated a decreased capacity to learn and an early memory loss, suggesting frontal executive and attention type deficits.Moreover, the decreased PVT scores demonstrated an impact on crystallized intelligence, indicating decline in verbal skills, semantic knowledge, or retrieval.Overall, the observed deficits in different cognitive domains support early neurocognitive screening even when OALWH do not show overt signs of neurocognitive impairment.

ASSESSMENT OF ELECTROLYTE ABNORMALITIES IN OLDER ADULTS WITH COVID-19 DELIRIUM
Milenko Petrovic, Esther Park, Amanda Pangle, Jeanne Wei, and Gohar Azhar, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States This retrospective study explored the impact of COVID-19 on altered sodium and potassium in older adults with delirium.EMRs from the University of Arkansas for Medical Sciences (UAMS) database were reviewed from January 7, 2018 to January 5, 2021 for electrolyte abnormalities and delirium.Inclusion criteria were age 65 or older, all races, genders, and ethnicities with COVID or non-COVID infections.We identified 319 patients with COVID-19 out of which 108 (33.8%) had delirium during COVID.In COVID-delirious patients, hypokalemia was present in 8, hyperkalemia in 10, hyponatremia in 9, and hypernatremia in 20.127/319 (39.8%)COVID patients had an electrolyte disorder at some point with hypokalemia being most represented at 58/127 (45.7%).Out of the patients who experienced hypokalemia at some point, 34/319 (10.6%) had delirium.In another cohort of 306 older adults with non-COVID pneumonias we identified 173 patients with electrolyte disorders and 106 (34.6%) with delirium during pneumonia.Electrolyte disturbances were more present in non-COVID pneumonias vs. those with COVID (p< 0.001).Hypokalemia was more identified in non-COVID, 56/306 (18.3%), vs. COVID patients, 34/319 (10.6%) (p< 0.006).Interestingly, hypernatremia was greater in COVID groups (p< 0.0321).There was no difference in delirium between COVID vs non-COVID patients, but electrolytes disorders and hypokalemia were observed with greater frequency in non-COVID pneumonias.Notably, hypernatremia developed more in patients suffering from COVID and since it can be associated with seizures and cerebral hemorrhage, particular attention should be paid to prevent hypernatremia from developing in order to reduce COVID-related morbidity and mortality.There has been an increasingly important trend that more and more older people take part in activities of digital technology nowadays in China.In this study, the research question associated to determinants of older people's digital engagement was addressed, which has been quantitatively analyzed by statistical models in a sample of older people 60 to 98 years of age from China Longitudinal Aging Social Survey (N=11207).For dependent variable, digital participation of older people has been measured by the access to the Internet with mobile phones and various digital devices, whereas for independent variables, individual, situational, environmental, and social policy factors which were based on a conceptual model of productive aging framework have been constructed to present academic explanations on dependent variable.Results of Probit and Ordered-Probit regression showed that the older people's participation in digital technology was closely related to individual and situational factors, whereas the effects of environmental factors and social policies were not statistically significant.Older adults who were much younger and physically healthier had higher probability of participation in digital technology.Meanwhile, those who lived in urban area, had higher levels on income, literacy and social support were more likely to be involved in digital activities.Conclusions shed light on the significance of academic research to improve productive ageing and successful ageing which takes a more active role on exploring and grappling with issues related to application of digital technology especially technological difficulties that older people have confronted with in an ageing society.

ASSOCIATION AND RISK PREDICTION OF PAIN AND FALL-RELATED INJURIES AMONG COMMUNITY-DWELLING OLDER ADULTS IN CHINA
Xiaodong Chen, Kewei Shi, Lingxiao He, and Ya Fang, Xiamen University, Xiamen, Fujian, China (People's Republic) Background: Pain is common in older adults and has also been identified as a fall risk factor, whereas the impact and mechanism of fall-related injuries are still unknown.This study aims to examine the association and risk prediction of pain and fall-related injuries among Chinese older adults.Method: This study enrolled 5,721 older adults from the China Health andRetirement Longitudinal Study (wave 2011-2015).Logistic regression was used to analyze the associations between pain characteristics and fall-related injuries.Furthermore, 2022 older adults with pain at baseline were further used to build a fall-related injury prediction model, using five machine learning algorithms (logistic regression, naive bayesian, random forest, adaptive boosting and artificial neural network) with 118 input variables as candidate features, and SHapley Additive exPlanations was used for the prediction model explanation.Results: Logistic regression models showed that whether pain (OR=1.35)or pain severity (ORmoderate=1.37,ORsevere =1.48) and multisite pain (OR=1.41)independently predicted fall-related injuries.The Random forest model achieved the best performance among the prediction model with an area under the receiver operating characteristic curve of 0.764.Interpretable results showed that the top 10 significant predictors were: experience of falling, frailty, sex, short physical performance battery, received inpatient care, estimated glomerular filtration rate, lung function, pain quantity, White Blood Cell and Age.Conclusions: Pain is associated with fall-related injuries among Chinese older adults.Fall-related injury prevention strategies for older adults with pain should specifically focus on fall history, frailty, and women.

ASSOCIATION BETWEEN FRAILTY AND FIVE-YEAR MORTALITY AFTER HIP FRACTURE SURGERY IN OLDER PATIENTS.
Jung-Yeon Choi, and Kwang-il Kim, Seoul National University Bundang Hospital, Seoul, Republic of Korea We aimed to identify the association between frailty and 5-year mortality after hip fracture surgery.The Hip-Multidimensional Frailty Score (Hip-MFS) was calculated using the Comprehensive Geriatric Assessment (CGA).The primary outcome was 5-year mortality.Among 1,363 patients who underwent HF surgery, 598 (44%) patients underwent CGA, and 536 patients were included in the final analysis.The mean age was 80.5 years and 71.3% were females.A total of 223 (41.6%) patients experienced postoperative complications.The median observation time was 1999.5 days, and the overall mortality rate was 60.4% (n = 324), whereas the 1-year mortality and the 5-year mortality rate after HF surgery were 13.8% (n = 74) and 42.8% (n = 235), respectively.In the multivariate regression analysis, after accounting for clinical and demographic factors, the high-risk Hip-MFS group and the group with postoperative complications had hazard ratios of 1.49 (95% confidence interval [CI] 1.090-2.037,p = 0.012) and 1.498 (95% CI 1.139-1.970,p = 0.004), respectively.Patients with postoperative complications with low Hip-MFS showed better 5-year survival than those without postoperative complications with high hip-MFS in the Kaplan-Meier curve (p = 0.013).Compared with the occurrence of postoperative complications, the frailty status evaluated with the Hip-MFS had a more significant impact on long-term mortality after hip fracture surgery.This study assessed whether late-life education (LLE) was associated with better cognitive function and whether the benefits of LLE on cognitive decline differed by gender, race/ ethnicity, and education level in a nationally-representative sample of U.S. older adults.We conducted a retrospective cohort study using six waves of data from the Health and Retirement Study ([HRS] 2008-2018) that included adults aged ≥ 65 with no baseline diagnosis of Alzheimer's disease and related dementias (ADRD).Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7's test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range=0-35).LLE was measured at every wave and was categorized as "once a month or more," and "not in the last month [or never]."Covariates included participants' demographic background, socioeconomic status, psychosocial and behavioral factors, and health-related factors.Of 12,099 participants (median age 71 [IQR=10]), engaging in LLE at least once a month or more was associated with better cognitive function and was equivalent to a 2-4 year delay in cognitive decline than